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[null,"California CoPower ONE \nRate Areas and SIC Codes"]
["CA DPPO Rate Area Definitions"]
["Region 1",null,null,"Region 2"]
["ZIP Codes 900–908, 910–928, 930, 932–933, 935–938, 952–953, and 956–958.\nThe following ZIP Codes are excluded from Region 1 but included in Region 2: \n92222, 92227, 92231–92233, 92243–92244, 92249–92251, 92257, 92259, 92266, 92273, 92275, 92281, 92283, 92328, 92384, 92389, 93013, 93014, 93067, 93512–93515, 93517, 93522, 93526, 93529–93530, 93541–93542, 93545–93546, 93549, 95646, 95724, 95728",null,null,"ZIP Codes: 931, 934, 939–951, 954–955, 959–961, 92222, \n92227, 92231–92233, 92243–92244, 92249–92251, 92257, 92259, 92266, 92273, 92275, 92281, 92283, 92328, 92384, 92389, 93013–93014, 93067, 93512–93515, 93517, 93522, 93526, 93529–93530, 93541–93542, 93545–93546, 93549, 95646, 95724, 95728"]
[]
["CA DHMO Rate Area Definitions"]
["Region 1 and Region 2",null,null,"Region 3"]
["Los Angeles",null,null,"Alameda","Mariposa","San Francisco"]
["Orange",null,null,"Contra Costa","Riverside","San Mateo"]
[null,null,null,"Fresno","San Bernardino","Santa Clara"]
[null,null,null,"Kern","San Diego","Ventura"]
["Region 4",null,null,"Region 5"]
["Alpine","Marin","San Luis Obispo","Butte","Mendocino","Siskiyou"]
["Amador","Merced","Santa Barbara","Del Norte","Modoc","Sutter"]
["Calaveras","Monterey","Sierra","Glenn","Mono","Tehama"]
["Colusa","Napa","Solano","Humboldt","San Benito","Trinity"]
["El Dorado","Nevada","Sonoma","Lake","Santa Cruz","Yuba"]
["Imperial","Placer","Stanislaus","Lassen","Shasta"]
["Inyo","Plumas","Tuolumne"]
["Kings","Sacramento","Tulare"]
["Madera","San Joaquin","Yolo"]
[]
["SIC Level Classifications"]
["Level 1 Eligible Industries - Delta Dental (DPPO)"]
["Advertising (except Misc., not classified 7319)",null,"7311-7313","Hospitals",null,"8062-8069"]
["Agriculture, Forestry, Fishing \n(except seasonal employees)",null,"0100-0999","Independent Auto Repair and Services",null,"7532-7599"]
["Auto Rental Agencies",null,"7513-7519","Laundry/Garment Service/Show Repair Services",null,"7211-7219, \n7251"]
["Automobile Parking Services",null,7521,"Manufacturing (except Jewelry Manufacturing)",null,"2000-2699"]
["Building Maintenance / Equipment Rental",null,"7349-7359","Manufacturing (Chemicals, Allied and Other)",null,"2810-3999"]
["Collection Agencies and Credit Reporting Services",null,"7322-7323","Mining, Oil and Gas Extraction",null,"1000-1499"]
["Communication \n(Radio, Telephone, TV/Radio Broadcasting)",null,"4800-4899","Miscellaneous Repair \n(Welding, etc)",null,"7692-7699"]
["Community Services Organizations / Social Services",null,"8300-8499","Museum Art Galleries and Gardens",null,"8412, 8422"]
["Computer Programming and Other Computer Services",null,"7371-7379","New Syndicates",null,7383]
["Construction Contractors",null,"1500-1799","Photofinishing Labs",null,7384]
["Direct Mailing, Reproduction, Secretarial Services",null,"7331-7338","Printing and Publishing",null,"2700-2799"]
["Disinfecting and Pest Control Services",null,7342,"Public Administration \n(Cities, Counties, Police, etc)",null,"9000-9720, \n9722-9998"]
["Government Funded Groups   ",null,"8300-8499","Public and Private Schools \n(Elementary and High School)",null,"8200-8299"]
["Electrical Repair \n(Radio, TV, A/C, Refrigerator)",null,"7622-7629","Retail",null,"5200-5510, \n5610-5699, \n5712-5736, \n5912-5999"]
["Engineering and Management Services",null,"8711-8748","Security Systems, Detectives, Armored Car",null,"7381-7382"]
["Finance (Banks, Securities, Credit Agencies)",null,"6000-6299","Transportation",null,"4000-4799"]
["Funeral Services and Crematories",null,7261,"Utilities",null,"4900-4999"]
["Furniture Repair/Reupholstery",null,7641,"Wholesale Trade",null,"5000-5199"]
["Misc. Computer Services          ",null,7379]
["Level 2 Eligible Industries - Delta Dental (DPPO)"]
["Advertising (Miscellaneous, not classified)",null,7319,"Medical Groups",null,"8000-8059,\n8082-8099"]
["Automobile Dealerships",null,"5511-5599","Photographic Studios",null,7221]
["Amusement, Recreation, and Entertainment",null,"7800-7999","Restaurants",null,"5800-5899"]
["Hotels",null,"7000-7099","Tax Return Preparation Services /\nMisc. Personal Svcs",null,"7291-7299"]
["Insurance Carriers/Brokers",null,"6300-6499","Real Estate",null,"6500-6799"]
["Jewelry Manufacturing",null,"3911-3915","Religious Organizations (Admin. And Mgmt. staff only)",null,8661]
["Legal",null,"8100-8199","Watch, Clock and Jewelry Repair",null,7631]
["Management Carve-out (any industry)  ",null,9999]
["Ineligible Industries - Delta Dental (DPPO)"]
["Associations and Trusts1",null,"8600-8660, \n8662-8699","Religious Organizations \n(except Churches #8661)   ",null,"No SIC"]
["Beauty and Barber Shops",null,"7231-7241","Private Households",null,8811]
["International Affairs",null,9721,"Partnerships",null,"No SIC"]
["Dental Offices, Dental Labs, and Medical Labs",null,"8021, 8071, 8072","Seasonal Employees (Christmas/Part-time Help)",null,"No SIC"]
["Employment Agencies & PEOs",null,"7361-7363","Seasonal Employees (Agriculture)",null,"0761-0783"]
["Groups with high turnover2",null,"Varies","Miscellaneous Services not classified elsewhere",null,8999]
["Miscellaneous Business Services",null,7389]
["Ineligible Industries - DeltaCare® USA (DHMO)"]
["Law firms, associations, groups with seasonal employment, groups without an employee/employer relationship and businesses with high turnover2 are not eligible for any DeltaCare® USA plan. "]
[]
["Ineligible Industries - UNUM (Life)"]
["All groups in the cannabis or cannabis related industries are ineligible for life coverage. However, cannabis groups are still eligible for CoPower ONE Voluntary which does not include UNUM (Life)."]
[]
[]
["1  Management and administrative staff of associations and trusts are eligible at Level 2. Use SIC Code 9999."]
["2 A business has high turnover if 20% or more of the average number of its employees during the past 12 months were newly hired for reasons other than the growth of the business."]

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[]
[]
[]
[]
[null,null,null,null,null,null,null,null,{"$f":"IF(AND(HMO_EligibleEEs=\"2-9 Employees\",F14>9),\"Total enrolling employees higher than eligible employees (2-9). Change eligible or enrolling employees.\",\"\")","v":""}]
[]
["Company Information"]
["Company Name:",null,null,null,null,null,null,null,{"$f":"IF(H12=\"Yes\",,\"Must have a minimum of 2 enrolled for Good plan\")","v":"Must have a minimum of 2 enrolled for Good plan"}]
["Effective Date:","Select your effective date",null,null,null,null,null,null,{"$f":"IF(H13=\"Yes\",,\"Must have a minimum of 5 enrolled for Better and Best plans\")","v":"Must have a minimum of 5 enrolled for Better and Best plans"}]
[null,null,null,null,null,"Enrolling Employees",null,null,{"$f":"IF(OR(AND(OR(HMO_EligibleEEs=\"Enter Number of Employees\",HMO_EligibleEEs=\"2-9 Employees\"),OR(B13=\"Enhanced Life $50,000\",B13=\"Enhanced Life $100,000\",B13=\"Enhanced Life $150,000\")),AND((SUM(G13)<10),OR(B13=\"Enhanced Life $50,000\",B13=\"Enhanced Life $100,000\",B13=\"Enhanced Life $150,000\"))),\"Enhanced Life is only available for CoPower ONE plans with 10+ enrolling employees.\",)","v":0}]
["Eligible Employees","Select your group size",null,"Number of Single",null,0,{"$f":"IF(GroupSize>100,\"100+\",IF(GroupSize>49,\"50-99\",IF(AND(GroupSize>9,GroupSize<50),\"10-49\",IF(AND(GroupSize<10,GroupSize>4),\"5-9\",\"2-4\"))))","v":"2-4"}]
["Region","Select your CA DHMO Region",null,"Number of Two Party",null,0,{"$f":"SUM(F11+F12+F13)","v":0},{"$f":"IF(SUM(G12)>1,\"Yes\",\"No\")","v":"No"}]
["Life Amount2","Standard Life Amount",null,"Number of Three Party+",null,0,{"$f":"SUM(F11+F12+F13)","v":0},{"$f":"IF(SUM(G13)>4,\"Yes\",\"No\")","v":"No"},{"$f":"IF(OR(I8=\"Must have a minimum of 2 enrolled for Good plan\",I5=\"Total enrolling employees higher than eligible employees (2-9). Change eligible or enrolling employees.\",I10=\"Enhanced Life is only available for CoPower ONE plans with 10+ enrolling employees.\"),1,0)","v":1},"Good Check"]
[null,null,null,"Total Enrolling Employees",null,{"$f":"F13+F12+EECOunt_HMO_Single","v":0},null,null,{"$f":"IF(OR(I9=\"Must have a minimum of 5 enrolled for Better and Best plans\",I10=\"Enhanced Life is only available for CoPower ONE plans with 10+ enrolling employees.\",I5=\"Total enrolling employees higher than eligible employees (2-9). Change eligible or enrolling employees.\"),1,0)","v":1},"Better/Best Check"]
[]
["Cost Comparison - Monthly Rates"]
[]
[{"$f":"CONCATENATE(B12,B13,G11)","v":"Select your CA DHMO RegionStandard Life Amount2-4"},null,"Good",null,"Better",null,"Best"]
[]
["Single",null,{"$f":"_xlfn.IFNA(IF(I13=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,2,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(I14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,5,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(I14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,8,FALSE)),\"\")","v":""}]
["Two Party",null,{"$f":"_xlfn.IFNA(IF(I13=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,3,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(I14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,6,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(I14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,9,FALSE)),\"\")","v":""}]
["Three Party+",null,{"$f":"_xlfn.IFNA(IF(I13=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,4,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(I14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,7,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(I14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,10,FALSE)),\"\")","v":""}]
["Total Cost",null,{"$f":"IFERROR(SUM((C20*F11)+(C21*F12)+(C22*F13)),\"\")","v":""},null,{"$f":"IFERROR(SUM((E20*F11)+(E21*F12)+(E22*F13)),\"\")","v":""},null,{"$f":"IFERROR(SUM((G20*F11)+(G21*F12)+(G22*F13)),\"\")","v":""}]
[]
["Benefit Comparison"]
[]
[null,null,"Good",null,"Better",null,"Best"]
[null,null,"In Network","Out of Network","In Network","Out of Network","In Network","Out of Network"]
["DHMO - DeltaCare® USA",null,"DeltaCare® USA Plan 13B"]
["Calendar Maximum (Per Patient)",null,"None",null,null,null,"None"]
["Deductible (Per Patient)",null,"None",null,null,null,"None"]
["Diagnostic & Preventive ",null,"Exams, x-rays, cleanings, and flouride treatments",null,null,null,"No cost"]
["Basic Restorative",null,"Fillings (amalgam cost per surface)",null,null,null,"No cost"]
["Periodontics",null,"Scaling and Root planing",null,null,null,"$50 copay"]
["Endodontics",null,"Root canal – anterior teeth (excluding final restoration)\nRoot canal – molar (excluding final restoration)",null,null,null,"$95 copay\n$335 copay"]
["Oral Surgery",null,"Extraction, erupted tooth or exposed root\nSurgical removal of erupted tooth requiring removal of bone or sectioning of tooth\nRemoval of impacted tooth – completely boney",null,null,null,"$5 copay\n$45 copay\n$95 copay"]
["Prosthodontics",null,"Crown – porcelain fused to high noble metal; full cast high noble metal\nComplete denture – maxillary\nMaxillary partial denture – resin base",null,null,null,"$355 copay\n$285 copay\n$245 copay"]
["Orthodontics",null,"Child\nAdult",null,null,null,"$1,900 copay\n$2,100 copay"]
["Vision - Vision Service Plan"]
["Annual Copayment",null,"$25 exam/$25 materials",null,"$10 exam/$25 materials",null,"$10 exam/$25 materials"]
["Eye Exam",null,"Covered in full*","Reimbursed \nup to $45","Covered in full*","Reimbursed \nup to $45","Covered in full*","Reimbursed \nup to $45"]
["Single-vision Lenses",null,"Covered in full*","Reimbursed\nup to $30","Covered in full*","Reimbursed\nup to $30","Covered in full*","Reimbursed\nup to $30"]
["Bifocal Lenses",null,"Covered in full*","Reimbursed \nup to $50","Covered in full*","Reimbursed \nup to $50","Covered in full*","Reimbursed \nup to $50"]
["Trifocal Lenses",null,"Covered in full*","Reimbursed\nup to $65","Covered in full*","Reimbursed\nup to $65","Covered in full*","Reimbursed\nup to $65"]
["Frames",null,"$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70"]
["Contact Lenses",null,"$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105"]
[null,null,"Good",null,"Better",null,"Best"]
["Vision - Frequency"]
["Eye Exam",null,"12 months",null,"12 months",null,"12 months"]
["Lenses",null,"24 months",null,"12 months",null,"12 months"]
["Frames",null,"24 months",null,"24 months",null,"12 months"]
["Contact Lenses \n(in lieu of lenses and a frame)",null,"24 months",null,"12 months",null,"12 months"]
["Life - UNUM"]
["Basic Group Term Life \nwith AD&D and EAP",null,{"$f":"IF($B$13=\"Standard Life Amount\",\"$15,000 policy\",$B$13)","v":"$15,000 policy"},null,{"$f":"IF($B$13=\"Standard Life Amount\",\"$20,000 policy\",$B$13)","v":"$20,000 policy"},null,{"$f":"IF($B$13=\"Standard Life Amount\",\"$25,000 policy\",$B$13)","v":"$25,000 policy"}]
["1  2-year rate guarantee"]
["2 Employers with 10 or more enrolling employees have the option of substituting the standard group term life policy amounts with either a $50,000, $100,000 or $150,000 policy for an additional charge."]
["* After Copay"]
[]
["Presented by"]
["**Enter your contact information here.**",null,null,null,null,"License #"]
["This document is not meant to replace a quote and does not include all exclusions, limitations or program guidelines. While the information and rates provided here are believed to be accurate as of the print date, they are subject to change without notice. For the most up-to-date information, contact CoPower. CoPower ONE plans are not available to groups currently insured with UNUM."]

{"sheet":"CoPower One DPPO Comparison","index":2,"n_rows":63,"n_cols":12,"rows_kept":63,"cut":false,"hidden":false,"merged":[[51,8,51,9],[53,6,53,7],[51,2,51,3],[51,4,51,5],[50,6,50,7],[39,2,39,3],[36,6,36,7],[53,8,53,9],[48,4,48,5],[39,8,39,9],[49,2,49,3],[50,2,50,3],[50,8,50,9],[49,6,49,7],[37,8,37,9],[36,4,36,5],[36,8,36,9],[37,2,37,3],[22,2,22,3],[47,8,47,9],[48,8,48,9],[37,6,37,7],[14,3,14,5],[15,3,15,5],[5,10,7,10],[35,4,35,5],[23,2,23,3],[10,10,11,10],[12,3,12,5],[13,3,13,5],[53,4,53,5],[36,0,36,1],[39,0,39,1],[40,0,40,1],[41,0,41,1],[36,2,36,3],[37,0,37,1],[38,0,38,1],[47,0,47,1],[48,0,48,1],[47,2,47,3],[48,2,48,3],[45,0,45,1],[39,4,39,5],[28,4,28,5],[16,0,16,9],[24,2,24,3],[19,4,19,5],[69,8,69,9],[63,8,63,9],[64,8,64,9],[65,8,65,9],[66,8,66,9],[55,0,55,9],[62,0,62,9],[67,8,67,9],[68,8,68,9],[60,0,60,2],[56,0,56,9],[57,0,57,9],[61,0,61,6],[61,7,61,9],[60,3,60,9],[58,0,58,9],[39,6,39,7],[35,8,35,9],[53,0,53,1],[53,2,53,3],[20,0,20,1],[52,0,52,9],[44,0,44,1],[50,0,50,1],[51,6,51,7],[47,4,47,5],[42,0,42,1],[43,0,43,1],[50,4,50,5],[51,0,51,1],[46,0,46,9],[49,4,49,5],[49,0,49,1],[25,6,25,7],[25,4,25,5],[48,6,48,7],[47,6,47,7],[49,8,49,9],[28,6,28,7],[22,6,22,7],[24,6,24,7],[20,6,20,7],[35,0,35,1],[37,4,37,5],[19,11,21,11],[33,0,33,1],[24,4,24,5],[20,8,20,9],[30,0,30,1],[31,0,31,1],[34,0,34,1],[33,8,33,9],[28,8,28,9],[30,2,30,5],[34,8,34,9],[32,0,32,1],[30,6,30,9],[25,2,25,3],[19,6,19,7],[21,6,21,7],[28,2,28,3],[24,8,24,9],[19,8,19,9],[22,8,22,9],[22,4,22,5],[21,4,21,5],[20,2,20,5],[25,8,25,9],[54,0,54,9],[7,3,7,9],[7,0,7,2],[17,3,17,9],[17,0,17,2],[26,3,26,9],[26,0,26,2],[23,8,23,9],[21,2,21,3],[23,6,23,7],[8,1,8,9],[14,1,14,2],[23,4,23,5],[21,8,21,9],[9,1,9,2],[23,0,23,1],[21,0,21,1],[12,1,12,2],[13,1,13,2],[22,0,22,1],[24,0,24,1],[11,1,11,2],[19,2,19,3],[35,6,35,7]]}
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AND(PPO_EligibleEEs=\"2-9 Employees\",G16>9),\"Total enrolling employees higher than eligible employees (2-9). Change eligible or enrolling employees.\",\"\")","v":""}]
[]
["Company Information"]
["Company Name:",null,null,null,null,null,null,null,null,null,{"$f":"IF(J14=\"Yes\",,\"Must have a minimum of 2 enrolled for Good plan\")","v":"Must have a minimum of 2 enrolled for Good plan"}]
["Effective Date:","Select your effective date",null,null,null,null,null,null,null,null,{"$f":"IF(J15=\"Yes\",,\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\")","v":"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans"}]
[null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AND(OR(PPO_EligibleEEs=\"Enter Number of Employees\",PPO_EligibleEEs=\"2-9 Employees\"),OR(B15=\"Enhanced Life $50,000\",B15=\"Enhanced Life $100,000\",B15=\"Enhanced Life $150,000\")),AND((SUM(I14)<10),OR(B15=\"Enhanced Life $50,000\",B15=\"Enhanced Life $100,000\",B15=\"Enhanced Life $150,000\"))),\"Enhanced Life is only available for CoPower ONE plans with 10+ enrolling employees.\",)","v":0}]
["Eligible Employees","Select your group size",null,null,null,null,"Enrolling Employees"]
["Region","Select your CA PPO Region",null,"Number of Single",null,null,0,null,{"$f":"IF(GroupSize>100,\"100+\",IF(GroupSize>49,\"50-99\",IF(AND(GroupSize>9,GroupSize<50),\"10-49\",IF(AND(GroupSize<10,GroupSize>4),\"5-9\",\"2-4\"))))","v":"2-4"},null,{"$f":"IF(OR(K9=\"Must have a minimum of 2 enrolled for Good plan\",K11=\"Enhanced Life is only available for CoPower ONE plans with 10+ enrolling employees.\",K6=\"Total enrolling employees higher than eligible employees (2-9). Change eligible or enrolling employees.\"),1,0)","v":1},"Good Chk"]
["SIC Level","Select your SIC Level",null,"Number of Two Party",null,null,0,null,{"$f":"SUM(G13+G14+G15)","v":0},{"$f":"IF(SUM(I14)>1,\"Yes\",\"No\")","v":"No"},{"$f":"IF(OR(K9=\"Must have a minimum of 2 enrolled for Good plan\",K10=\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\",K11=\"Enhanced Life is only available for CoPower ONE plans with 10+ enrolling employees.\",K6=\"Total enrolling employees higher than eligible employees (2-9). Change eligible or enrolling employees.\"),1,0)","v":1},"Better/BetterPlus/Best Chk"]
["Life Amount2","Standard Life Amount",null,"Number of Three Party+",null,null,0,null,{"$f":"SUM(G13+G14+G15)","v":0},{"$f":"IF(SUM(I15)>4,\"Yes\",\"No\")","v":"No"}]
[null,null,null,"Total Enrolling Employees",null,null,{"$f":"EECount_PPO_Single+G14+G15","v":0}]
[]
["Cost Comparison - Monthly Rates"]
[]
[{"$f":"CONCATENATE(B13,B14,B15,I13)","v":"Select your CA PPO RegionSelect your SIC LevelStandard Life Amount2-4"},{"$f":"SUM(CPPPO_EECheck)","v":0},"Good",null,"Better",null,"Better Plus",null,"Best"]
[]
["Single",null,{"$f":"_xlfn.IFNA(IF(K13=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,2,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,5,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,8,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,11,FALSE)),\"\")","v":""}]
["Two Party",null,{"$f":"_xlfn.IFNA(IF(K13=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,3,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,6,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,9,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,12,FALSE)),\"\")","v":""}]
["Three Party+",null,{"$f":"_xlfn.IFNA(IF(K13=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,4,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,7,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,10,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K14=1,\"\",VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,13,FALSE)),\"\")","v":""}]
["Total Cost",null,{"$f":"IFERROR(SUM((C22*G13)+(C23*G14)+(C24*G15)),\"\")","v":""},null,{"$f":"IFERROR(SUM((E22*G13)+(E23*G14)+(E24*G15)),\"\")","v":""},null,{"$f":"IFERROR(SUM((G22*G13)+(G23*G14)+(G24*G15)),\"\")","v":""},null,{"$f":"IFERROR(SUM((I22*G13)+(I23*G14)+(I24*G15)),\"\")","v":""}]
[]
["Benefit Comparison"]
[]
[null,null,"Good",null,"Better",null,"Better Plus",null,"Best"]
[null,null,"In Network","Out of Network","In Network","Out of Network","In Network","Out of Network","In Network","Out of Network"]
["DPPO - Delta Dental",null,"Delta Dental DPPO3",null,null,null,"Delta Dental DPPO + Premier4"]
["Calendar Maximum (Per Patient)",null,"$1,000","$750","$1,500","$1,250","$1,500","$1,250","$2,000","$1,500"]
["Deductible (Per Patient)",null,"$50","$75","$50","$75","$50","$75","$50","$75"]
["Deductible Waived for Diagnostic & Preventive",null,"Yes","No","Yes","No","Yes","No","Yes"]
["Diagnostic and\nPreventive Services",null,"100%","50%","100%","80%","100%","80%","100%"]
["Basic, Oral Surgery, \nEndodontics and Periodontics",null,"80%","50%","80%",null,"80%",null,"80%"]
["Major Services",null,"50%",null,"50%",null,"50%",null,"50%"]
["Orthodontics-Children Only\n(Available to groups 5+ enrolled)",null,"Not available",null,"50% lifetime max $1,000",null,"50% lifetime max $1,000",null,"50% lifetime max $1,000"]
["Vision - Vision Service Plan"]
["Annual Copayment",null,"$25 exam/$25 materials",null,"$10 exam/$25 materials",null,"$10 exam/$25 materials",null,"$10 exam/$25 materials"]
["Eye Exam",null,"Covered in full*","Reimbursed \nup to $45","Covered in full*","Reimbursed \nup to $45","Covered in full*","Reimbursed \nup to $45","Covered in full*","Reimbursed \nup to $45"]
["Single-vision Lenses",null,"Covered in full*","Reimbursed\nup to $30","Covered in full*","Reimbursed\nup to $30","Covered in full*","Reimbursed\nup to $30","Covered in full*","Reimbursed\nup to $30"]
["Bifocal Lenses",null,"Covered in full*","Reimbursed \nup to $50","Covered in full*","Reimbursed \nup to $50","Covered in full*","Reimbursed \nup to $50","Covered in full*","Reimbursed \nup to $50"]
["Trifocal Lenses",null,"Covered in full*","Reimbursed\nup to $65","Covered in full*","Reimbursed\nup to $65","Covered in full*","Reimbursed\nup to $65","Covered in full*","Reimbursed\nup to $65"]
["Frames",null,"$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70"]
["Contact Lenses",null,"$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105"]
["Vision - Frequency"]
["Eye Exam",null,"12 months",null,"12 months",null,"12 months",null,"12 months"]
["Lenses",null,"24 months",null,"12 months",null,"12 months",null,"12 months"]
["Frames",null,"24 months",null,"24 months",null,"24 months",null,"12 months"]
["Contact Lenses \n(in lieu of lenses and a frame)",null,"24 months",null,"12 months",null,"12 months",null,"12 months"]
[null,null,"Good",null,"Better",null,"Better Plus",null,"Best"]
["Life - UNUM"]
["Basic Group Term Life \nwith AD&D and EAP",null,{"$f":"IF($B$15=\"Standard Life Amount\",\"$15,000 policy\",$B$15)","v":"$15,000 policy"},null,{"$f":"IF($B$15=\"Standard Life Amount\",\"$20,000 policy\",$B$15)","v":"$20,000 policy"},null,{"$f":"IF($B$15=\"Standard Life Amount\",\"$20,000 policy\",$B$15)","v":"$20,000 policy"},null,{"$f":"IF($B$15=\"Standard Life Amount\",\"$25,000 policy\",$B$15)","v":"$25,000 policy"}]
["1 2-year rate guarantee "]
["2 Employers with 10 or more enrolling employees have the option of substituting the standard group term life policy amounts with either a $50,000, $100,000 or $150,000 policy for an additional charge."]
["3 Delta Dental DPPO: All dentists (in- and out-of-network) are reimbursed at the lesser of the submitted charge or the DPPO provider's allowed fee."]
["4 Delta Dental DPPO + Premier: DPPO dentists are reimbursed at the lesser of the submitted charge or the DPPO provider allowed fee. Delta Dental Premier dentists are reimbursed at the lesser of the submitted charge or the Premier provider allowed fee. Non-contracted dentists are reimbursed at the lesser of the submitted charge or the fee that satisfies the majority of dentists with the same training and geographical area."]
["* After Copay"]
[]
["Presented by"]
["**Enter your contact information here.**",null,null,null,null,null,null,"License #"]
["This document is not meant to replace a quote and does not include all exclusions, limitations or program guidelines. While the information and rates provided here are believed to be accurate as of the print date, they are subject to change without notice. For the most up-to-date information, contact CoPower. CoPower ONE plans are not available to groups currently insured with UNUM."]

{"sheet":"CoPower One Non-Vol Dual Choice","index":3,"n_rows":79,"n_cols":15,"rows_kept":79,"cut":false,"hidden":false,"merged":[[30,0,30,2],[28,8,28,9],[17,0,17,2],[4,10,7,10],[77,7,77,9],[21,4,21,5],[65,2,65,3],[65,4,65,5],[64,6,64,7],[65,6,65,7],[52,2,52,3],[72,0,72,9],[68,0,68,9],[70,0,70,9],[42,2,42,9],[41,8,41,9],[39,4,39,5],[32,8,32,9],[34,6,34,9],[40,8,40,9],[39,6,39,7],[40,6,40,7],[38,0,38,1],[23,0,23,1],[41,6,41,7],[22,6,22,7],[23,6,23,7],[39,8,39,9],[21,8,21,9],[22,8,22,9],[23,8,23,9],[26,8,26,9],[25,8,25,9],[27,6,27,7],[29,8,29,9],[21,6,21,7],[43,0,43,1],[34,0,34,1],[34,2,34,5],[39,0,39,1],[37,0,37,1],[41,0,41,1],[41,2,41,3],[41,4,41,5],[40,0,40,1],[40,2,40,3],[40,4,40,5],[54,8,54,9],[52,8,52,9],[52,4,52,5],[54,0,54,1],[54,6,54,7],[52,6,52,7],[37,8,37,9],[53,0,53,1],[27,2,27,3],[27,4,27,5],[49,2,49,8],[50,2,50,8],[42,0,42,1],[51,2,51,8],[43,2,43,8],[44,0,44,1],[46,2,46,8],[48,2,48,8],[45,2,45,8],[44,2,44,8],[48,0,48,1],[49,0,49,1],[35,0,35,1],[27,8,27,9],[45,0,45,1],[46,0,46,1],[51,0,51,1],[50,0,50,1],[52,0,52,1],[47,0,47,1],[54,2,54,3],[54,4,54,5],[55,0,55,1],[62,0,62,1],[62,2,62,3],[62,4,62,5],[62,8,62,9],[62,6,62,7],[56,0,56,1],[57,0,57,1],[58,0,58,1],[60,0,60,1],[83,8,83,9],[84,8,84,9],[85,8,85,9],[78,0,78,9],[79,8,79,9],[80,8,80,9],[81,8,81,9],[6,0,6,9],[82,8,82,9],[66,0,66,1],[67,0,67,1],[67,2,67,3],[67,4,67,5],[27,0,27,1],[63,8,63,9],[67,8,67,9],[64,0,64,1],[67,6,67,7],[63,0,63,1],[63,2,63,3],[63,4,63,5],[75,3,75,9],[76,0,76,9],[75,0,75,2],[71,0,71,9],[64,8,64,9],[65,0,65,1],[77,0,77,6],[64,2,64,3],[64,4,64,5],[47,2,47,8],[9,1,9,2],[32,2,32,3],[32,4,32,5],[36,0,36,1],[32,6,32,7],[38,8,38,9],[22,0,22,1],[22,2,22,3],[22,4,22,5],[20,6,20,7],[19,6,19,7],[19,2,19,3],[21,0,21,1],[63,6,63,7],[65,8,65,9],[61,0,61,1],[59,0,59,1],[12,10,14,10],[14,4,14,5],[9,10,11,10],[16,0,16,9],[12,4,12,5],[13,4,13,5],[8,1,8,9],[10,6,10,7],[15,10,17,10],[15,4,15,5],[26,2,26,3],[19,8,19,9],[20,0,20,1],[20,8,20,9],[26,4,26,5],[28,6,28,7],[23,2,23,3],[29,4,29,5],[25,6,25,7],[26,6,26,7],[21,2,21,3],[28,0,28,1],[28,2,28,3],[28,4,28,5],[23,4,23,5],[69,0,69,9],[7,11,7,12],[8,11,8,12],[9,11,11,12],[12,11,14,12],[15,11,17,12],[11,1,11,2],[12,1,12,2],[13,1,13,2],[14,1,14,2],[15,1,15,2],[7,3,7,9],[17,3,17,9],[30,3,30,9],[7,0,7,2],[20,2,20,3],[20,4,20,5],[24,8,24,9],[25,0,25,1],[25,2,25,3],[25,4,25,5],[19,4,19,5],[24,0,24,1],[26,0,26,1]]}
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AND(HP_EligibleEEs=\"2-9 Employees\",SUM(G16,H16)>9),\"Total enrolling employees higher than eligible employees (2-9). Change eligible or enrolling employees.\",\"\")","v":""}]
[]
[]
["Company Information",null,null,null,null,null,null,null,null,null,null,"Enrolling>Eligible Check"]
["Company Name:",null,null,null,null,null,null,null,null,null,{"$f":"IF(SUM(G16:H16=0),\"\",IF(J16=\"Yes\",,\"Dual Choice requires a minimum of 4 enrolled. \"))","v":"Dual Choice requires a minimum of 4 enrolled. "},"Dual Choice 4 EE Minimum Check"]
["Effective Date:","Select your effective date",null,null,null,null,null,null,null,null,{"$f":"IF(I15=\"Yes\",,\"CoPower ONE Good: Dual Choice requires a minimum of 2 enrolled in both the DHMO and PPO option.\")","v":"CoPower ONE Good: Dual Choice requires a minimum of 2 enrolled in both the DHMO and PPO option."},"Good Dual Choice 2 EE on Each Plan Minimum Check"]
[null,null,null,null,{"$f":"IF(GroupSize_Dual>49,\"50-99\",IF(AND(GroupSize_Dual>9,GroupSize_Dual<50),\"10-49\",IF(AND(GroupSize_Dual<10,GroupSize_Dual>4),\"5-9\",\"2-4\")))","v":"2-4"},{"$f":"SUM(GroupSize_Dual+H16)","v":0},"Enrolling Employees"]
["Eligible Employees","Select your group size",null,null,{"$f":"IF(F11>100,\"100+\",IF(F11>49,\"50-99\",IF(AND(F11>9,F11<50),\"10-49\",IF(AND(F11<10,F11>4),\"5-9\",\"2-4\"))))","v":"2-4"},null,"DPPO","DHMO"]
["PPO Region","Select your CA PPO Region",null,null,"Number of Single",null,0,0,{"$f":"IF(SUM(G13:G15)<2,\"0\",\"1\")","v":"0"},{"$f":"IF(SUM(G13:G15)<5,\"0\",\"1\")","v":"0"},{"$f":"IF(J15=\"Yes\",,\"CoPower ONE Better, Better Plus, and Best: Dual Choice requires a minimum of 5 enrolled in PPO and 2 enrolled in the DHMO option.\")","v":"CoPower ONE Better, Better Plus, and Best: Dual Choice requires a minimum of 5 enrolled in PPO and 2 enrolled in the DHMO option."},"Better / Better Plus / Best Dual Choice 5 EE on PPO and 2 EE on HMO Check"]
["DHMO Region","Select your CA DHMO Region",null,null,"Number of Two Party",null,0,0,{"$f":"IF(SUM(H13:H15)<2,\"0\",\"1\")","v":"0"},{"$f":"IF(SUM(H13:H15)<2,\"0\",\"1\")","v":"0"}]
["SIC Level","Select your SIC Level",null,null,"Number of Three Party+",null,0,0,{"$f":"IF(SUM(I13+I14)>=2,\"Yes\",\"No\")","v":"No"},{"$f":"IF(SUM(J13+J14)>=2,\"Yes\",\"No\")","v":"No"}]
["Life Amount3","Standard Life Amount",null,null,"Total Enrolling Employees",null,{"$f":"SUM(G13+G14+G15)","v":0},{"$f":"SUM(H13+H14+H15)","v":0},null,{"$f":"IF(SUM(G16+H16)>3,\"Yes\",\"No\")","v":"No"},{"$f":"IF(OR(AND(OR(PPO_EligibleEEs=\"Enter Number of Employees\",PPO_EligibleEEs=\"2-9 Employees\"),OR(B16=\"Enhanced Life $50,000\",B16=\"Enhanced Life $100,000\",B16=\"Enhanced Life $150,000\")),AND((SUM(G16:H16)<10),OR(B16=\"Enhanced Life $50,000\",B16=\"Enhanced Life $100,000\",B16=\"Enhanced Life $150,000\"))),\"Enhanced Life is only available for CoPower ONE plans with 10+ enrolling employees.\",)","v":0},"Enhanced Life Messaging"]
["."]
["Cost Comparison - Monthly Rates"]
[]
[{"$f":"IF(AND(OR(B16=\"Enhanced Life $50,000\",B16=\"Enhanced Life $100,000\",B16=\"Enhanced Life $150,000\"),SUM(G16:H16)>9),CONCATENATE(B13,B15,B16,E12),CONCATENATE(B13,B15,B16,E11))","v":"Select your CA PPO RegionSelect your SIC LevelStandard Life Amount2-4"},{"$f":"CONCATENATE(B14,B16,E12)","v":"Select your CA DHMO RegionStandard Life Amount2-4"},"Good",null,"Better",null,"Better Plus",null,"Best",null,{"$f":"IF(OR(K9=\"Dual Choice requires a minimum of 4 enrolled. \",K10=\"CoPower ONE Good: Dual Choice requires a minimum of 2 enrolled in both the DHMO and PPO option.\",K16=\"Enhanced Life is only available for CoPower ONE plans with 10+ enrolling employees.\",K5=\"Total enrolling employees higher than eligible employees (2-9). Change eligible or enrolling employees.\"),1,0)","v":1},"Good Checks"]
["DPPO Enrollment",null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(K9=\"Dual Choice requires a minimum of 4 enrolled. \",K10=\"CoPower ONE Good: Dual Choice requires a minimum of 2 enrolled in both the DHMO and PPO option.\",K13=\"CoPower ONE Better, Better Plus, and Best: Dual Choice requires a minimum of 5 enrolled in PPO and 2 enrolled in the DHMO option.\",K16=\"Enhanced Life is only available for CoPower ONE plans with 10+ enrolling employees.\",K5=\"Total enrolling employees higher than eligible employees (2-9). Change eligible or enrolling employees.\"),1,0)","v":1},"Better / Better Plus / Best Checks"]
["Single",null,{"$f":"_xlfn.IFNA(IF(K20=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,2,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,5,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,8,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,11,FALSE)),\"\")","v":""}]
["Two Party",null,{"$f":"_xlfn.IFNA(IF(K20=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,3,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,6,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,9,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,12,FALSE)),\"\")","v":""}]
["Three Party+",null,{"$f":"_xlfn.IFNA(IF(K20=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,4,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,7,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,10,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionPPO,List_RateTable_PPO,13,FALSE)),\"\")","v":""},null,null,{"$f":"IF(K20=1,\"\",IF(SUM($G$13:$G$15)>0,SUM(($G$13*C22)+($G$14*C23)+($G$15*C24)),0))","v":""},{"$f":"IF(K21=1,\"\",IF(SUM($G$13:$G$15)>0,SUM(($G$13*E22)+($G$14*E23)+($G$15*E24)),0))","v":""},{"$f":"IF(K21=1,\"\",IF(SUM($G$13:$G$15)>0,SUM(($G$13*G22)+($G$14*G23)+($G$15*G24)),0))","v":""},{"$f":"IF(K21=1,\"\",IF(SUM($G$13:$G$15)>0,SUM(($G$13*I22)+($G$14*I23)+($G$15*I24)),0))","v":""}]
["DHMO Enrollment"]
["Single",null,{"$f":"_xlfn.IFNA(IF(K20=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,2,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,5,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,5,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,8,FALSE)),\"\")","v":""}]
["Two Party",null,{"$f":"_xlfn.IFNA(IF(K20=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,3,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,6,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,6,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,9,FALSE)),\"\")","v":""}]
["Three Party+",null,{"$f":"_xlfn.IFNA(IF(K20=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,4,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,7,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,7,FALSE)),\"\")","v":""},null,{"$f":"_xlfn.IFNA(IF(K21=1,\"\",VLOOKUP(AreaSIC_SelectionHMO,List_RateTable_HMO,10,FALSE)),\"\")","v":""},null,null,{"$f":"IF(K20=1,\"\",IF(SUM($H$13:$H$15)>0,SUM(($H$13*C26)+($H$14*C27)+($H$15*C28)),0))","v":""},{"$f":"IF(K21=1,\"\",IF(SUM($H$13:$H$15)>0,SUM(($H$13*E26)+($H$14*E27)+($H$15*E28)),0))","v":""},{"$f":"IF(K21=1,\"\",IF(SUM($H$13:$H$15)>0,SUM(($H$13*G26)+($H$14*G27)+($H$15*G28)),0))","v":""},{"$f":"IF(K21=1,\"\",IF(SUM($H$13:$H$15)>0,SUM(($H$13*I26)+($H$14*I27)+($H$15*I28)),0))","v":""}]
["Total Cost",null,{"$f":"IFERROR(IF(K20=1,\"\",SUM(L24+L28)),\"\")","v":""},null,{"$f":"IFERROR(IF(K21=1,\"\",SUM(M24+M28)),\"\")","v":""},null,{"$f":"IFERROR(IF(K21=1,\"\",SUM(N24+N28)),\"\")","v":""},null,{"$f":"IFERROR(IF(K21=1,\"\",SUM(O24+O28)),\"\")","v":""}]
[]
["Benefit Comparison"]
[]
[null,null,"Good",null,"Better",null,"Better Plus",null,"Best"]
[null,null,"In Network","Out of Network","In Network","Out of Network","In Network","Out of Network","In Network","Out of Network"]
["DPPO - Delta Dental",null,"Delta Dental DPPO4",null,null,null,"Delta Dental DPPO + Premier5"]
["Calendar Maximum (Per Patient)",null,"$1,000","$750","$1,500","$1,250","$1,500","$1,250","$2,000","$1,500"]
["Deductible (Per Patient)",null,"$50","$75","$50","$75","$50","$75","$50","$75"]
["Deductible Waived for \nDiagnostic & Preventive",null,"Yes","No","Yes","No","Yes","No","Yes"]
["Diagnostic and\nPreventive Services",null,"100%","50%","100%","80%","100%","80%","100%"]
["Basic, Oral Surgery, \nEndodontics and Periodontics",null,"80%","50%","80%",null,"80%",null,"80%"]
["Major Services",null,"50%",null,"50%",null,"50%",null,"50%"]
["Orthodontics-Children Only\n(Available to groups 5+ enrolled)",null,"Not available",null,"50% lifetime max $1,000",null,"50% lifetime max $1,000",null,"50% lifetime max $1,000"]
["DHMO - DeltaCare® USA",null,"DeltaCare® USA Plan 13B"]
["Calendar Maximum (Per Patient)",null,"None",null,null,null,null,null,null,"None"]
["Deductible (Per Patient)",null,"None",null,null,null,null,null,null,"None"]
["Diagnostic & Preventive ",null,"Exams, x-rays, cleanings, and flouride treatments",null,null,null,null,null,null,"No cost"]
["Basic Restorative",null,"Fillings (amalgam cost per surface)",null,null,null,null,null,null,"No cost"]
["Periodontics",null,"Scaling and Root planing",null,null,null,null,null,null,"$50 copay"]
["Endodontics",null,"Root canal – anterior teeth (excluding final restoration)\nRoot canal – molar (excluding final restoration)",null,null,null,null,null,null,"$95 copay\n$335 copay"]
["Oral Surgery",null,"Extraction, erupted tooth or exposed root\nSurgical removal of erupted tooth requiring removal of bone or sectioning of tooth\nRemoval of impacted tooth – completely boney",null,null,null,null,null,null,"$5 copay\n$45 copay\n$95 copay"]
["Prosthodontics",null,"Crown – porcelain fused to high noble metal; full cast high noble metal\nComplete denture – maxillary\nMaxillary partial denture – resin base",null,null,null,null,null,null,"$355 copay\n$285 copay\n$245 copay"]
["Orthodontics",null,"Child\nAdult",null,null,null,null,null,null,"$1,900 copay\n$2,100 copay"]
[null,null,"Good",null,"Better",null,"Better Plus",null,"Best"]
["Vision - Vision Service Plan"]
["Annual Copayment",null,"$25 exam/$25 materials",null,"$10 exam/$25 materials",null,"$10 exam/$25 materials",null,"$10 exam/$25 materials"]
["Eye Exam",null,"Covered in full*","Reimbursed \nup to $45","Covered in full*","Reimbursed \nup to $45","Covered in full*","Reimbursed \nup to $45","Covered in full*","Reimbursed \nup to $45"]
["Single-vision Lenses",null,"Covered in full*","Reimbursed\nup to $30","Covered in full*","Reimbursed\nup to $30","Covered in full*","Reimbursed\nup to $30","Covered in full*","Reimbursed\nup to $30"]
["Bifocal Lenses",null,"Covered in full*","Reimbursed \nup to $50","Covered in full*","Reimbursed \nup to $50","Covered in full*","Reimbursed \nup to $50","Covered in full*","Reimbursed \nup to $50"]
["Trifocal Lenses",null,"Covered in full*","Reimbursed\nup to $65","Covered in full*","Reimbursed\nup to $65","Covered in full*","Reimbursed\nup to $65","Covered in full*","Reimbursed\nup to $65"]
["Frames",null,"$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70"]
["Contact Lenses",null,"$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105"]
["Vision - Frequency"]
["Eye Exam",null,"12 months",null,"12 months",null,"12 months",null,"12 months"]
["Lenses",null,"24 months",null,"12 months",null,"12 months",null,"12 months"]
["Frames",null,"24 months",null,"24 months",null,"24 months",null,"12 months"]
["Contact Lenses \n(in lieu of lenses and a frame)",null,"24 months",null,"12 months",null,"12 months",null,"12 months"]
["Life - UNUM"]
["Basic Group Term Life \nwith AD&D and EAP",null,{"$f":"IF($B$16=\"Standard Life Amount\",\"$15,000 policy\",$B$16)","v":"$15,000 policy"},null,{"$f":"IF($B$16=\"Standard Life Amount\",\"$20,000 policy\",$B$16)","v":"$20,000 policy"},null,{"$f":"IF($B$16=\"Standard Life Amount\",\"$20,000 policy\",$B$16)","v":"$20,000 policy"},null,{"$f":"IF($B$16=\"Standard Life Amount\",\"$25,000 policy\",$B$16)","v":"$25,000 policy"}]
["1 Groups of 4 may elect CoPower ONE Good, with 2 enrolled employees on the DPPO plan and a minimum of 2 on the DHMO plan. Dual Choice with CoPower ONE Better, Better Plus, and Best plans requires a minimum of 5 enrolled emplolyees on the DPPO plan and a minimum of 2 on the DHMO plan. Bundles cannot be mixed. CoPower ONE Good DPPO will pair with CoPower ONE Good DHMO. Better Plus DPPO will pair with Better DHMO. "]
["2 2-year rate guarantee"]
["3 Employers with 10 or more enrolling employees have the option of substituting the standard group term life policy amounts with either a $50,000, $100,000 or $150,000 policy for an additional charge"]
["4 Delta Dental DPPO: All dentists (in- and out-of-network) are reimbursed at the lesser of the submitted charge or the PPO provider allowed fee."]
["5 Delta Dental DPPO + Premier: DPPO dentists are reimbursed at the lesser of the submitted charge or the DPPO provider allowed fee. Delta Dental Premier dentists are reimbursed at the lesser of the submitted charge or the Premier provider allowed fee. Non-contracted dentists are reimbursed at the lesser of the submitted charge or the fee that satisfies the majority of dentists with the same training and geographical area."]
["* After Copay"]
[]
["Presented by"]
[]
["**Enter your contact information here.**",null,null,null,null,null,null,"License #"]
["This document is not meant to replace a quote and does not include all exclusions, limitations or program guidelines. While the information and rates provided here are believed to be accurate as of the print date, they are subject to change without notice. For the most up-to-date information, contact CoPower. CoPower ONE plans are not available to groups currently insured with UNUM."]

{"sheet":"CoPower ONE Vol","index":4,"n_rows":89,"n_cols":13,"rows_kept":89,"cut":false,"hidden":false,"merged":[[10,10,11,10],[14,10,16,10],[4,8,8,9],[8,0,8,2],[8,3,8,6],[9,1,9,7],[9,8,9,9],[10,1,10,2],[10,8,11,9],[11,5,11,6],[11,1,11,2],[15,3,15,4],[16,3,16,4],[14,8,16,9],[13,1,13,2],[12,1,12,2],[12,8,13,9],[13,3,13,4],[14,3,14,4],[25,0,25,1],[25,2,25,4],[25,5,25,7],[26,0,26,1],[26,2,26,4],[26,5,26,7],[20,0,20,2],[20,3,20,6],[23,2,23,7],[24,0,24,1],[24,2,24,4],[24,5,24,7],[30,0,30,1],[31,0,31,1],[31,2,31,4],[31,5,31,7],[32,0,32,1],[32,2,32,4],[32,5,32,7],[27,0,27,1],[27,2,27,4],[27,5,27,7],[28,0,28,1],[28,2,28,4],[28,5,28,7],[36,0,36,2],[36,3,36,6],[33,0,33,1],[33,2,33,4],[33,5,33,7],[34,0,34,1],[34,2,34,4],[34,5,34,7],[38,2,38,7],[39,0,39,1],[39,2,39,4],[39,5,39,7],[40,0,40,1],[40,2,40,7],[43,0,43,1],[43,2,43,4],[43,5,43,7],[44,1,45,1],[44,2,44,4],[44,5,44,7],[45,2,45,7],[41,0,41,1],[41,2,41,4],[41,5,41,7],[42,0,42,1],[42,2,42,4],[42,5,42,7],[52,0,52,1],[52,6,52,7],[53,0,53,1],[53,6,53,7],[54,0,54,1],[54,2,54,5],[54,6,54,7],[46,1,48,1],[46,2,46,7],[47,2,47,7],[48,2,48,7],[50,2,50,7],[51,0,51,1],[51,2,51,7],[57,0,57,1],[57,2,57,5],[57,6,57,7],[58,0,58,1],[58,2,58,5],[58,6,58,7],[55,0,55,1],[55,2,55,5],[55,6,55,7],[56,0,56,1],[56,2,56,5],[56,6,56,7],[63,2,63,7],[64,0,64,1],[64,2,64,4],[64,5,64,7],[65,0,65,1],[65,2,65,7],[59,0,59,1],[59,2,59,5],[59,6,59,7],[60,0,60,1],[60,2,60,5],[60,6,60,7],[68,0,68,1],[68,2,68,4],[68,5,68,7],[69,0,69,1],[69,2,69,4],[69,5,69,7],[66,0,66,1],[66,2,66,4],[66,5,66,7],[67,0,67,1],[67,2,67,4],[67,5,67,7],[72,0,72,1],[73,0,73,1],[73,2,73,7],[74,0,74,1],[74,2,74,7],[75,0,75,1],[75,2,75,7],[70,0,70,1],[70,2,70,4],[70,5,70,7],[71,0,71,1],[71,2,71,4],[71,5,71,7],[81,0,81,7],[82,0,82,7],[84,0,84,2],[86,0,86,4],[86,5,86,7],[76,0,76,1],[76,2,76,7],[77,0,77,1],[78,0,78,1],[78,2,78,7],[79,0,79,7],[93,8,93,9],[94,8,94,9],[95,8,95,9],[87,0,87,6],[88,0,88,7],[89,8,89,9],[90,8,90,9],[91,8,91,9],[92,8,92,9]]}
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,{"$f":"IF(AND(VOL_EligibleEEs<>\"Enter your group size\",GroupSize_DualVOLTotal>VOL_EligibleEEs),\"Total enrolling employees higher than eligible employees. Change eligible or enrolling employees.\",\"\")","v":""}]
[null,null,null,null,null,null,null,null,null,null,"<= Enrolled vs Eligible Check (If Enrolled > Eligible)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(I10<>\"\",I5<>\"\"),1,0)","v":0},"PPO W/O Ortho"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,F25=\"DPPO With Ortho (Not Available)\",I11<>\"\",I10<>\"\",I5<>\"\"),1,0)","v":1},"PPO W Ortho"]
["Company Information",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(I13<>\"\",I5<>\"\"),1,0)","v":0},"DHMO"]
["Company Name:",null,null,null,null,null,null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0),\"\",IF(GroupSize_DualVOLPPO>4,\"\",\"CoPower ONE Vol DPPO requires a minimum of 5 enrolled.\"))","v":""},null,"<= DPPO Check (Minimum 5 Enrolled)"]
["Effective Date:","Select your effective date",null,null,null,null,null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0),\"\",IF(GroupSize_DualVOLPPO>24,\"\",\"CoPower ONE Vol DPPO with Ortho requires a minimum of 25 enrolled.\"))","v":""},null,"<= DPPO Ortho Check (Minimum 25 Enrolled)"]
["Eligible Employees:","Enter your group size",null,null,{"$f":"SUM(GroupSize_DualVOLPPO+GroupSize_DualVOLHMO)","v":0},"Enrolling Employees"]
["DHMO Region:","Select your CA DHMO Region",null,null,null,"DPPO","DHMO",null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0),\"\",IF(GroupSize_DualVOLHMO>1,\"\",\"CoPower ONE Vol DHMO requires a minimum of 2 enrolled.\"))","v":""}]
["DPPO Child Ortho Available?",{"$f":"IF(VOL_EligibleEEs=\"Enter your group size\",\"Enter Eligible & Enrolling EEs\",IF(GroupSize_DualVOLTotal=0,\"Enter Enrolling EEs\",IF(L8=1,\"Not Available\",\"Available\")))","v":"Enter Eligible & Enrolling EEs"},null,"Number of Single",null,0,0,null,null,null,"<= DHMO Check (Minimum 2 Enrolled)"]
[null,null,null,"Number of Two Party",null,0,0,null,{"$f":"IF(OR(AND(VOL_EligibleEEs>9,GroupSize_DualVOLTotal>9,GroupSize_DualVOLPPO>4,GroupSize_DualVOLHMO>1),AND(VOL_EligibleEEs>9,GroupSize_DualVOLTotal>9,GroupSize_DualVOLPPO>4,GroupSize_DualVOLHMO>1)),\"CoPower ONE Vol Dual Choice is available. For cost comparison use 'Vol Dual Choice' tab.\",\"\")","v":""}]
[null,null,null,"Number of Three Party+",null,0,0]
[null,null,null,"Total Enrolling Employees",null,{"$f":"SUM(F14+F15+F16)","v":0},{"$f":"SUM(G14+G15+G16)","v":0}]
[]
[]
[]
["Cost Comparison - Monthly Rates"]
[]
[]
[null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L9=1),\"\",Region_VOL_HMO)","v":""},"CoPower ONE Voluntary"]
["DPPO Voluntary Enrollment",null,"DPPO Without Ortho",null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0),\"DPPO With Ortho\",IF(OR(GroupSize_DualVOLPPO<25,VOL_EligibleEEs<25),\"DPPO With Ortho (Not Available)\",\"DPPO With Ortho\"))","v":"DPPO With Ortho"}]
["Single",null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L7=1),\"\",_xlfn.IFNA(VLOOKUP(\"Without Ortho\",List_RateTable_VOLPPO,2,FALSE),\"\"))","v":""},null,null,{"$f":"IF(L8=1,\"\",_xlfn.IFNA(VLOOKUP(\"With Ortho\",List_RateTable_VOLPPO,2,FALSE),\"\"))","v":""}]
["Two Party",null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L7=1),\"\",_xlfn.IFNA(VLOOKUP(\"Without Ortho\",List_RateTable_VOLPPO,3,FALSE),\"\"))","v":""},null,null,{"$f":"IF(L8=1,\"\",_xlfn.IFNA(VLOOKUP(\"With Ortho\",List_RateTable_VOLPPO,3,FALSE),\"\"))","v":""}]
["Three Party+",null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L7=1),\"\",_xlfn.IFNA(VLOOKUP(\"Without Ortho\",List_RateTable_VOLPPO,4,FALSE),\"\"))","v":""},null,null,{"$f":"IF(L8=1,\"\",_xlfn.IFNA(VLOOKUP(\"With Ortho\",List_RateTable_VOLPPO,4,FALSE),\"\"))","v":""}]
["Total Cost-DPPO Only",null,{"$f":"IF(C26=\"\",\"\",IFERROR(IF(L7=1,\"\",SUM(L29)),\"\"))","v":""},null,null,{"$f":"IF(F26=\"\",\"\",IFERROR(IF(L8=1,\"\",SUM(M29)),\"\"))","v":""},null,null,null,null,null,{"$f":"IFERROR(IF(L7=1,\"\",IF(GroupSize_DualVOLPPO>0,SUM(($F$14*C26)+($F$15*C27)+($F$16*C28)),0)),\"\")","v":0},{"$f":"IFERROR(IF(L8=1,\"\",IF(GroupSize_DualVOLPPO>0,SUM(($F$14*F26)+($F$15*F27)+($F$16*F28)),0)),\"\")","v":""}]
[]
["DHMO Voluntary Enrollment"]
["Single",null,{"$f":"IF(L9=1,\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,2,FALSE),\"\"))","v":""},null,null,{"$f":"IF(OR(F25=\"DPPO With Ortho (Not Available)\",L9=1),\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,2,FALSE),\"\"))","v":""}]
["Two Party",null,{"$f":"IF(L9=1,\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,3,FALSE),\"\"))","v":""},null,null,{"$f":"IF(OR(F25=\"DPPO With Ortho (Not Available)\",L9=1),\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,3,FALSE),\"\"))","v":""}]
["Three Party+",null,{"$f":"IF(L9=1,\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,4,FALSE),\"\"))","v":""},null,null,{"$f":"IF(OR(F25=\"DPPO With Ortho (Not Available)\",L9=1),\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,4,FALSE),\"\"))","v":""}]
["Total Cost-DHMO Only",null,{"$f":"IF(C32=\"\",\"\",IFERROR(IF(L9=1,\"\",SUM(L35)),\"\"))","v":""},null,null,{"$f":"IF(F32=\"\",\"\",IFERROR(IF(OR(F25=\"With Ortho (Not Available)\",L9=1),\"\",SUM(M35)),\"\"))","v":""},null,null,null,null,null,{"$f":"IFERROR(IF(L9=1,\"\",IF(GroupSize_DualVOLHMO>0,SUM(($G$14*C32)+($G$15*C33)+($G$16*C34)),0)),\"\")","v":0},{"$f":"IFERROR(IF(L9=1,\"\",IF(GroupSize_DualVOLHMO>0,SUM(($G$14*F32)+($G$15*F33)+($G$16*F34)),0)),\"\")","v":0}]
[]
["Benefit Comparison"]
[]
[null,null,"CoPower ONE Voluntary DPPO"]
[null,null,"DPPO Dentists",null,null,"Non-DPPO Dentists"]
["DPPO Vol - Delta Dental",null,"Delta Dental DPPO2"]
["Calendar Year Max (per patient)",null,"$1,500",null,null,"$1,250"]
["Calendar Year Deductible (per patient)",null,"$50",null,null,"$75"]
["Deductible Waived for Diagnostic & Preventive",null,"Yes",null,null,"No"]
["Diagnostic and\nPreventive Services","First 12 Months","100%",null,null,"80%"]
["Basic Services (Sealants, Simple Restorations, & Simple Extractions)",null,"80%"]
["Oral Surgery, \nEndodontics and Periodontics","Second 12 Months","50%"]
["Major Services",null,"50%"]
["Orthodontics-Children Only\n(Available to groups with 25+ enrolled)",null,{"$f":"IF(OR(GroupSize_DualVOLPPO<25,VOL_EligibleEEs<25,L8=1),\"Not Available (Ortho option only available for groups with 25+ DPPO enrollees)\",\"Ortho option available for groups with 25+ DPPO enrollees - 50% lifetime max $1,000\")","v":"Not Available (Ortho option only available for groups with 25+ DPPO enrollees)"}]
[]
[null,null,"CoPower ONE Voluntary DHMO"]
["DHMO Vol - DeltaCare® USA",null,"DeltaCare® USA Plan 13B"]
["Calendar Maximum",null,"None",null,null,null,"None"]
["Deductible",null,"None",null,null,null,"None"]
["Diagnostic & Preventive ",null,"Exams, x-rays, cleanings, and flouride treatments",null,null,null,"No cost"]
["Restorative",null,"Fillings (amalgam cost per surface)\nCrown – porcelain fused to high noble metal; full cast high noble metal",null,null,null,"No cost\n$355 copay"]
["Periodontics",null,"Periodontic scaling & root planing—four or more teeth per quadrant",null,null,null,"$50 copay"]
["Endodontics",null,"Root canal – anterior teeth (excluding final restoration)\nRoot canal – molar (excluding final restoration)",null,null,null,"$95 copay\n$335 copay"]
["Oral Surgery",null,"Extraction, erupted tooth or exposed root\nRemoval of impacted tooth – completely boney",null,null,null,"$5 copay\n$95 copay"]
["Prosthodontics",null,"Complete denture – maxillary\nMaxillary partial denture – resin base",null,null,null,"$285 copay\n$245 copay"]
["Orthodontics",null,"Child\nAdult",null,null,null,"$1,900 copay\n$2,100 copay"]
[]
[]
[null,null,"CoPower ONE Voluntary"]
["Vision - Vision Service Plan",null,"In Network",null,null,"Out of Network"]
["Annual Copayment",null,"$10 exam/$25 materials"]
["Eye Exam",null,"Covered in full*",null,null,"Reimbursed up to $45"]
["Single-Vision Lenses",null,"Covered in full*",null,null,"Reimbursed up to $30"]
["Bifocal Lenses",null,"Covered in full*",null,null,"Reimbursed up to $50"]
["Trifocal Lenses",null,"Covered in full*",null,null,"Reimbursed up to $65"]
["Frames",null,"$150 allowance",null,null,"Reimbursed up to $70"]
["Contact Lenses",null,"$150 allowance",null,null," Reimbursed up to $105"]
["Vision - Frequency"]
["Eye Exam",null,"12 months"]
["Lenses",null,"12 months"]
["Frames",null,"24 months"]
["Contact Lenses (in lieu of lenses and a frame)",null,"12 months"]
["Life - UNUM"]
["Basic Group Term Life with AD&D and EAP",null,"N/A"]
[]
["1 2-year rate guarantee"]
["2 Delta Dental DPPO: All dentists (in- and out-of-network) are reimbursed at the lesser of the submitted charge or the DPPO provider's contracted fee."]
["* After Copay"]
[]
["Presented by"]
[]
["**Enter your contact information here.**",null,null,null,null,"License #"]
[]
["This document is not meant to replace a quote and does not include all exclusions, limitations or program guidelines. While the information and rates provided here are believed to be accurate as of the print date, they are subject to change without notice. For the most up-to-date information, contact CoPower. CoPower ONE plans are not available to groups currently insured with UNUM."]

{"sheet":"CoPower ONE Vol Dual Choice","index":5,"n_rows":92,"n_cols":13,"rows_kept":92,"cut":false,"hidden":false,"merged":[[96,8,96,9],[97,8,97,9],[98,8,98,9],[15,8,17,9],[90,0,90,6],[91,0,91,7],[92,8,92,9],[93,8,93,9],[94,8,94,9],[95,8,95,9],[82,0,82,7],[84,0,84,7],[85,0,85,7],[87,0,87,2],[89,0,89,4],[89,5,89,7],[78,0,78,1],[78,2,78,7],[79,0,79,1],[80,0,80,1],[80,2,80,7],[81,0,81,7],[74,0,74,1],[75,0,75,1],[75,2,75,7],[76,0,76,1],[76,2,76,7],[77,0,77,1],[77,2,77,7],[72,0,72,1],[72,2,72,4],[72,5,72,7],[73,0,73,1],[73,2,73,4],[73,5,73,7],[70,0,70,1],[70,2,70,4],[70,5,70,7],[71,0,71,1],[71,2,71,4],[71,5,71,7],[68,0,68,1],[68,2,68,4],[68,5,68,7],[69,0,69,1],[69,2,69,4],[69,5,69,7],[65,2,65,7],[66,0,66,1],[66,2,66,4],[66,5,66,7],[67,0,67,1],[67,2,67,7],[61,0,61,1],[61,2,61,5],[61,6,61,7],[62,0,62,1],[62,2,62,5],[62,6,62,7],[59,0,59,1],[59,2,59,5],[59,6,59,7],[60,0,60,1],[60,2,60,5],[60,6,60,7],[57,0,57,1],[57,2,57,5],[57,6,57,7],[58,0,58,1],[58,2,58,5],[58,6,58,7],[54,0,54,1],[54,6,54,7],[55,0,55,1],[55,6,55,7],[56,0,56,1],[56,2,56,5],[56,6,56,7],[48,1,50,1],[48,2,48,7],[49,2,49,7],[50,2,50,7],[52,2,52,7],[53,0,53,1],[53,2,53,7],[45,0,45,1],[45,2,45,4],[45,5,45,7],[46,1,47,1],[46,2,46,4],[46,5,46,7],[47,2,47,7],[43,0,43,1],[43,2,43,4],[43,5,43,7],[44,0,44,1],[44,2,44,4],[44,5,44,7],[40,2,40,7],[41,0,41,1],[41,2,41,4],[41,5,41,7],[42,0,42,1],[42,2,42,7],[36,0,36,1],[36,2,36,4],[36,5,36,7],[37,8,37,9],[38,0,38,2],[38,3,38,6],[33,0,33,1],[33,2,33,4],[33,5,33,7],[34,0,34,1],[34,2,34,4],[34,5,34,7],[30,0,30,1],[31,0,31,1],[31,2,31,4],[31,5,31,7],[32,0,32,1],[32,2,32,4],[32,5,32,7],[27,0,27,1],[27,2,27,4],[27,5,27,7],[28,0,28,1],[28,2,28,4],[28,5,28,7],[25,0,25,1],[25,2,25,4],[25,5,25,7],[26,0,26,1],[26,2,26,4],[26,5,26,7],[20,0,20,2],[20,3,20,6],[23,2,23,7],[24,0,24,1],[24,2,24,4],[24,5,24,7],[8,0,8,2],[8,3,8,6],[9,1,9,7],[10,1,10,2],[5,8,7,9],[8,8,9,9],[14,1,14,2],[14,3,14,4],[14,10,16,10],[15,3,15,4],[16,3,16,4],[12,8,14,9],[10,10,11,10],[11,1,11,2],[11,5,11,6],[12,1,12,2],[13,1,13,2],[13,3,13,4],[10,8,11,9]]}
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,{"$f":"IF(AND(VOL_EligibleEEs<>\"Enter your group size\",GroupSize_DualVOLTotal>VOL_EligibleEEs),\"Total enrolling employees higher than eligible employees. Change eligible or enrolling employees.\",\"\")","v":""},null,"<= Enrolled vs Eligible Check (If Enrolled > Eligible)"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(I9<>\"\",I6<>\"\"),1,0)","v":0},"PPO W/O Ortho"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,F25=\"DPPO With Ortho (Not Available)\",I11<>\"\",I6<>\"\"),1,0)","v":1},"PPO W Ortho"]
["Company Information",null,null,null,null,null,null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0),\"\",IF(AND(I6=\"\",VOL_EligibleEEs>4,GroupSize_DualVOLPPO>4),\"CoPower ONE Vol DPPO (Without Dual Choice) is available. For cost comparison use 'CoPower ONE Vol' tab.\",\"\"))","v":""},null,null,{"$f":"IF(OR(I13<>\"\",I6<>\"\"),1,0)","v":0},"DHMO"]
["Company Name:",null,null,null,null,null,null,null,null,null,"<= DPPO Check (Minimum 5 Enrolled)",{"$f":"IF(OR(I16<>\"\",I6<>\"\"),1,0)","v":0},"Dual Choice"]
["Effective Date:","Select your effective date",null,null,null,null,null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0),\"\",IF(GroupSize_DualVOLPPO>24,\"\",\"CoPower ONE Vol DPPO with Ortho requires a minimum of 25 enrolled.\"))","v":""},null,"<= DPPO Ortho Check (Minimum 25 Enrolled)"]
["Eligible Employees:","Enter your group size",null,null,{"$f":"SUM(GroupSize_DualVOLPPO+GroupSize_DualVOLHMO)","v":0},"Enrolling Employees"]
["DHMO Region:","Select your CA DHMO Region",null,null,null,"DPPO","DHMO",null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0),\"\",IF(AND(I6=\"\",GroupSize_DualVOLHMO>1),\"CoPower ONE Vol DHMO (Without Dual Choice) is available. For cost comparison use 'CoPower ONE Vol' tab.\",\"\"))","v":""}]
["Dual Choice Available?",{"$f":"IF(VOL_EligibleEEs=\"Enter your group size\",\"Enter Eligible & Enrolling EEs\",IF(GroupSize_DualVOLTotal=0,\"Enter Enrolling EEs\",IF(L10=1,\"Not Available\",\"Available\")))","v":"Enter Eligible & Enrolling EEs"},null,"Number of Single",null,0,0,null,null,null,"<= DHMO Check (Minimum 2 Enrolled)"]
["DPPO Child Ortho Available?",{"$f":"IF(VOL_EligibleEEs=\"Enter your group size\",\"Enter Eligible & Enrolling EEs\",IF(GroupSize_DualVOLTotal=0,\"Enter Enrolling EEs\",IF(L8=1,\"Not Available\",\"Available\")))","v":"Enter Eligible & Enrolling EEs"},null,"Number of Two Party",null,0,0,null,null,null,"<= Dual Choice: 10 total enrolled, 5 on one plan check"]
[null,null,null,"Number of Three Party+",null,0,0,null,{"$f":"IF(OR(GroupSize_DualVOLTotal=0,VOL_EligibleEEs=\"Enter your group size\"),\"\",IF(GroupSize_DualVOLTotal<10,\"CoPower ONE Vol Dual Choice requires minimum of 10 enrolled, with minimum of 5 enrolled in one plan and remainder in the other.\",IF(OR(AND(GroupSize_DualVOLTotal>9,GroupSize_DualVOLPPO>4,GroupSize_DualVOLHMO>1),(AND(GroupSize_DualVOLTotal>9,GroupSize_DualVOLPPO>1,GroupSize_DualVOLHMO>4))),\"\",\"CoPower ONE Vol Dual Choice requires minimum of 10 enrolled, with minimum of 5 enrolled in one plan and remainder in the other.\")))","v":""}]
[null,null,null,"Total Enrolling Employees",null,{"$f":"SUM(F14+F15+F16)","v":0},{"$f":"SUM(G14+G15+G16)","v":0}]
[]
[]
[]
["Cost Comparison - Monthly Rates"]
[]
[]
[null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L10=1),\"\",Region_VOL_HMO)","v":""},"CoPower ONE Voluntary - Dual Choice"]
["DPPO Voluntary Enrollment",null,"DPPO Without Ortho",null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0),\"DPPO With Ortho\",IF(OR(GroupSize_DualVOLPPO<25,VOL_EligibleEEs<25,I6<>\"\"),\"DPPO With Ortho (Not Available)\",\"DPPO With Ortho\"))","v":"DPPO With Ortho"}]
["Single",null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L10=1),\"\",_xlfn.IFNA(VLOOKUP(\"Without Ortho\",List_RateTable_VOLPPO,2,FALSE),\"\"))","v":""},null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L10=1,L8=1),\"\",_xlfn.IFNA(VLOOKUP(\"With Ortho\",List_RateTable_VOLPPO,2,FALSE),\"\"))","v":""}]
["Two Party",null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L10=1),\"\",_xlfn.IFNA(VLOOKUP(\"Without Ortho\",List_RateTable_VOLPPO,3,FALSE),\"\"))","v":""},null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L10=1,L8=1),\"\",_xlfn.IFNA(VLOOKUP(\"With Ortho\",List_RateTable_VOLPPO,3,FALSE),\"\"))","v":""}]
["Three Party+",null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L10=1),\"\",_xlfn.IFNA(VLOOKUP(\"Without Ortho\",List_RateTable_VOLPPO,4,FALSE),\"\"))","v":""},null,null,{"$f":"IF(OR(VOL_EligibleEEs=\"Enter your group size\",GroupSize_DualVOLTotal=0,L10=1,L8=1),\"\",_xlfn.IFNA(VLOOKUP(\"With Ortho\",List_RateTable_VOLPPO,4,FALSE),\"\"))","v":""}]
["Total Cost-DPPO",null,{"$f":"IF(C26=\"\",\"\",IFERROR(IF(L10=1,\"\",SUM(L29)),\"\"))","v":""},null,null,{"$f":"IF(F26=\"\",\"\",IFERROR(IF(OR(L8=1,L10=1),\"\",SUM(M29)),\"\"))","v":""},null,null,null,null,null,{"$f":"IFERROR(IF(L10=1,\"\",IF(GroupSize_DualVOLPPO>0,SUM(($F$14*C26)+($F$15*C27)+($F$16*C28)),0)),\"\")","v":0},{"$f":"IFERROR(IF(OR(L8=1,L10=1),\"\",IF(GroupSize_DualVOLPPO>0,SUM(($F$14*F26)+($F$15*F27)+($F$16*F28)),0)),\"\")","v":""}]
[]
["DHMO Voluntary Enrollment"]
["Single",null,{"$f":"IF(L10=1,\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,2,FALSE),\"\"))","v":""},null,null,{"$f":"IF(OR(F25=\"DPPO With Ortho (Not Available)\",L10=1),\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,2,FALSE),\"\"))","v":""}]
["Two Party",null,{"$f":"IF(L10=1,\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,3,FALSE),\"\"))","v":""},null,null,{"$f":"IF(OR(F25=\"DPPO With Ortho (Not Available)\",L10=1),\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,3,FALSE),\"\"))","v":""}]
["Three Party+",null,{"$f":"IF(L10=1,\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,4,FALSE),\"\"))","v":""},null,null,{"$f":"IF(OR(F25=\"DPPO With Ortho (Not Available)\",L10=1),\"\",_xlfn.IFNA(VLOOKUP(AreaSIC_SelectionVOLHMO,List_RateTable_VOLHMO,4,FALSE),\"\"))","v":""}]
["Total Cost-DHMO",null,{"$f":"IF(C32=\"\",\"\",IFERROR(IF(L10=1,\"\",SUM(L35)),\"\"))","v":""},null,null,{"$f":"IF(F32=\"\",\"\",IFERROR(IF(OR(F25=\"With Ortho (Not Available)\",L10=1),\"\",SUM(M35)),\"\"))","v":""},null,null,null,null,null,{"$f":"IFERROR(IF(L10=1,\"\",IF(GroupSize_DualVOLHMO>0,SUM(($G$14*C32)+($G$15*C33)+($G$16*C34)),0)),\"\")","v":0},{"$f":"IFERROR(IF(L10=1,\"\",IF(GroupSize_DualVOLHMO>0,SUM(($G$14*F32)+($G$15*F33)+($G$16*F34)),0)),\"\")","v":0}]
[]
["Total Cost-Dual Choice Voluntary",null,{"$f":"IF(OR(GroupSize_DualVOLTotal=0),\"\",IF(L10=1,\"Dual Choice Not Available\",IFERROR(SUM(C35+C29),\"\")))","v":""},null,null,{"$f":"IF(GroupSize_DualVOLTotal=0,\"\",IF(L10=1,\"Dual Choice Not Available\",IFERROR(SUM(F35+F29),\"\")))","v":""}]
[]
["Benefit Comparison"]
[]
[null,null,"CoPower ONE Voluntary DPPO"]
[null,null,"DPPO Dentists",null,null,"Non-DPPO Dentists"]
["DPPO Vol - Delta Dental",null,"Delta Dental DPPO3"]
["Calendar Year Max (per patient)",null,"$1,500",null,null,"$1,250"]
["Calendar Year Deductible (per patient)",null,"$50",null,null,"$75"]
["Deductible Waived for Diagnostic & Preventive",null,"Yes",null,null,"No"]
["Diagnostic and\nPreventive Services","First 12 Months","100%",null,null,"80%"]
["Basic Services (Sealants, Simple Restorations, & Simple Extractions)",null,"80%"]
["Oral Surgery, \nEndodontics and Periodontics","Second 12 Months","50%"]
["Major Services",null,"50%"]
["Orthodontics-Children Only\n(Available to groups with 25+ enrolled)",null,{"$f":"IF(OR(GroupSize_DualVOLPPO<25,VOL_EligibleEEs<25,L8=1),\"Not Available (Ortho option only available for groups with 25+ DPPO enrollees)\",\"Ortho option available for groups with 25+ DPPO enrollees - 50% lifetime max $1,000\")","v":"Not Available (Ortho option only available for groups with 25+ DPPO enrollees)"}]
[]
[null,null,"CoPower ONE Voluntary DHMO"]
["DHMO Vol - DeltaCare® USA",null,"DeltaCare® USA Plan 13B"]
["Calendar Maximum",null,"None",null,null,null,"None"]
["Deductible",null,"None",null,null,null,"None"]
["Diagnostic & Preventive ",null,"Exams, x-rays, cleanings, and flouride treatments",null,null,null,"No cost"]
["Restorative",null,"Fillings (amalgam cost per surface)\nCrown – porcelain fused to high noble metal; full cast high noble metal",null,null,null,"No cost\n$355 copay"]
["Periodontics",null,"Periodontic scaling & root planing—four or more teeth per quadrant",null,null,null,"$50 copay"]
["Endodontics",null,"Root canal – anterior teeth (excluding final restoration)\nRoot canal – molar (excluding final restoration)",null,null,null,"$95 copay\n$335 copay"]
["Oral Surgery",null,"Extraction, erupted tooth or exposed root\nRemoval of impacted tooth – completely boney",null,null,null,"$5 copay\n$95 copay"]
["Prosthodontics",null,"Complete denture – maxillary\nMaxillary partial denture – resin base",null,null,null,"$285 copay\n$245 copay"]
["Orthodontics",null,"Child\nAdult",null,null,null,"$1,900 copay\n$2,100 copay"]
[]
[]
[null,null,"CoPower ONE Voluntary"]
["Vision - Vision Service Plan",null,"In Network",null,null,"Out of Network"]
["Annual Copayment",null,"$10 exam/$25 materials"]
["Eye Exam",null,"Covered in full*",null,null,"Reimbursed up to $45"]
["Single-Vision Lenses",null,"Covered in full*",null,null,"Reimbursed up to $30"]
["Bifocal Lenses",null,"Covered in full*",null,null,"Reimbursed up to $50"]
["Trifocal Lenses",null,"Covered in full*",null,null,"Reimbursed up to $65"]
["Frames",null,"$150 allowance",null,null,"Reimbursed up to $70"]
["Contact Lenses",null,"$150 allowance",null,null," Reimbursed up to $105"]
["Vision - Frequency"]
["Eye Exam",null,"12 months"]
["Lenses",null,"12 months"]
["Frames",null,"24 months"]
["Contact Lenses (in lieu of lenses and a frame)",null,"12 months"]
["Life - UNUM"]
["Basic Group Term Life with AD&D and EAP",null,"N/A"]
[]
["1 Dual choice voluntary Delta Dental DPPO and DeltaCare® USA DHMO available for groups of 10+ enrolling - minimum of 5 enrolled in one plan and remainder in the other"]
["2 2-year rate guarantee"]
["3 Delta Dental DPPO: All dentists (in- and out-of-network) are reimbursed at the lesser of the submitted charge or the DPPO provider's contracted fee."]
["* After Copay"]
[]
["Presented by"]
[]
["**Enter your contact information here.**",null,null,null,null,"License #"]
[]
["This document is not meant to replace a quote and does not include all exclusions, limitations or program guidelines. While the information and rates provided here are believed to be accurate as of the print date, they are subject to change without notice. For the most up-to-date information, contact CoPower. CoPower ONE plans are not available to groups currently insured with UNUM."]

{"sheet":"Lists","index":6,"n_rows":139,"n_cols":16,"rows_kept":139,"cut":false,"hidden":true,"merged":[[51,4,51,6],[51,7,51,9],[51,10,51,12],[51,13,51,15],[0,13,0,15],[46,7,49,15],[0,10,0,12],[0,4,0,6],[0,7,0,9],[72,13,72,15],[134,4,134,6],[82,4,82,6],[82,7,82,9],[82,10,82,12],[72,4,72,6],[72,7,72,9],[72,10,72,12]]}
["List_Area_PPO","List_SIC",null,"List_RateTable_PPO","GOOD",null,null,"BETTER",null,null,"BETTER PLUS",null,null,"BEST"]
["Select your CA PPO Region","Select your SIC Level",null,"Region 21Standard Life Amount5-9",45,82.5,124,55.5,104.5,172.5,61.5,114,190.5,76,141.5,231]
["Region 1",1,null,"Region 22Standard Life Amount5-9",51.5,95,143,64,120,198,70,133.5,223,87.5,163.5,268.5]
["Region 2",2,null,"Region 11Standard Life Amount5-9",44,77.5,117,54.5,98,162.5,61.5,109.5,181.5,74,133.5,220.5]
[null,null,null,"Region 12Standard Life Amount5-9",50.5,90,136.5,63,114,188.5,69,126.5,212.5,85.5,155.5,255]
[]
[null,null,null,"Region 21Standard Life Amount10-49",45,82.5,124,55.5,104.5,172.5,61.5,114,190.5,76,141.5,231]
[null,null,null,"Region 22Standard Life Amount10-49",51.5,95,143,64,120,198,70,133.5,223,87.5,163.5,268.5]
[null,null,null,"Region 11Standard Life Amount10-49",44,77.5,117,54.5,98,162.5,61.5,109.5,181.5,74,133.5,220.5]
[null,null,null,"Region 12Standard Life Amount10-49",50.5,90,136.5,63,114,188.5,69,126.5,212.5,85.5,155.5,255]
[]
["List_EffDate","List_LifeAmounts",null,"Region 21Standard Life Amount50-99",45,82.5,124,55.5,104.5,172.5,61.5,114,190.5,76,141.5,231]
["Select your effective date","Standard Life Amount",null,"Region 22Standard Life Amount50-99",51.5,95,143,64,120,198,70,133.5,223,87.5,163.5,268.5]
["1/1/2023","Enhanced Life $50,000",null,"Region 11Standard Life Amount50-99",44,77.5,117,54.5,98,162.5,61.5,109.5,181.5,74,133.5,220.5]
["2/1/2023","Enhanced Life $100,000",null,"Region 12Standard Life Amount50-99",50.5,90,136.5,63,114,188.5,69,126.5,212.5,85.5,155.5,255]
["3/1/2023","Enhanced Life $150,000"]
["4/1/2023",null,null,"Region 21Enhanced Life $50,00010-49",{"$f":"SUM(E2+$E$74)","v":54.8},92.3,133.80000000000001,{"$f":"SUM(H2+$H$74)","v":63.9},112.9,180.9,69.900000000000006,122.4,198.9,{"$f":"SUM(N2+$N$74)","v":83},148.5,238]
["5/1/2023",null,null,"Region 22Enhanced Life $50,00010-49",61.3,104.8,152.80000000000001,72.400000000000006,128.4,206.4,78.400000000000006,141.9,231.4,94.5,170.5,275.5]
["6/1/2023",null,null,"Region 11Enhanced Life $50,00010-49",53.8,87.3,126.8,62.9,106.4,170.9,69.900000000000006,117.9,189.9,81,140.5,227.5]
["7/1/2023",null,null,"Region 12Enhanced Life $50,00010-49",60.3,99.8,146.30000000000001,71.400000000000006,122.4,196.9,77.400000000000006,134.9,220.9,92.5,162.5,262]
["8/1/2023"]
["9/1/2023",null,null,"Region 21Enhanced Life $100,00010-49",{"$f":"SUM(E2+$E$75)","v":68.8},106.3,147.80000000000001,{"$f":"SUM(H2+$H$75)","v":77.900000000000006},126.9,194.9,83.9,136.4,212.9,{"$f":"SUM(N2+$N$75)","v":97},162.5,252]
["10/1/2023",null,null,"Region 22Enhanced Life $100,00010-49",75.3,118.8,166.8,86.4,142.4,220.4,92.4,155.9,245.4,108.5,184.5,289.5]
["11/1/2023",null,null,"Region 11Enhanced Life $100,00010-49",67.8,101.3,140.80000000000001,76.900000000000006,120.4,184.9,83.9,131.9,203.9,95,154.5,241.5]
["12/1/2023",null,null,"Region 12Enhanced Life $100,00010-49",74.3,113.8,160.30000000000001,85.4,136.4,210.9,91.4,148.9,234.9,106.5,176.5,276]
[]
[null,null,null,"Region 21Enhanced Life $150,00010-49",{"$f":"SUM(E2+$E$76)","v":82.8},120.3,161.80000000000001,{"$f":"SUM(H2+$H$76)","v":91.9},140.9,208.9,97.9,150.4,226.9,{"$f":"SUM(N2+$N$76)","v":111},176.5,266]
[null,null,null,"Region 22Enhanced Life $150,00010-49",89.3,132.80000000000001,180.8,100.4,156.4,234.4,106.4,169.9,259.39999999999998,122.5,198.5,303.5]
["List_Area_HMO","List_EligibleEEs",null,"Region 11Enhanced Life $150,00010-49",81.8,115.3,154.80000000000001,90.9,134.4,198.9,97.9,145.9,217.9,109,168.5,255.5]
["Select your CA DHMO Region","Select your group size",null,"Region 12Enhanced Life $150,00010-49",88.3,127.8,174.3,99.4,150.4,224.9,105.4,162.9,248.9,120.5,190.5,290]
["Region 1 & 2","2-9 Employees"]
["Region 3","10-99 Employees",null,"Region 21Enhanced Life $50,00050-99",{"$f":"SUM(E2+$E$78)","v":52.7},90.2,131.69999999999999,{"$f":"SUM(H2+$H$78)","v":62.1},111.1,179.1,68.099999999999994,120.6,197.1,{"$f":"SUM(N2+$N$78)","v":81.5},147,236.5]
["Region 4",null,null,"Region 22Enhanced Life $50,00050-99",59.2,102.7,150.69999999999999,70.599999999999994,126.6,204.6,76.599999999999994,140.1,229.6,93,169,274]
["Region 5",null,null,"Region 11Enhanced Life $50,00050-99",51.7,85.2,124.7,61.1,104.6,169.1,68.099999999999994,116.1,188.1,79.5,139,226]
[null,null,null,"Region 12Enhanced Life $50,00050-99",58.2,97.7,144.19999999999999,69.599999999999994,120.6,195.1,75.599999999999994,133.1,219.1,91,161,260.5]
[]
[null,null,null,"Region 21Enhanced Life $100,00050-99",{"$f":"SUM(E2+$E$79)","v":63.7},101.2,142.69999999999999,{"$f":"SUM(H2+$H$79)","v":73.099999999999994},122.1,190.1,79.099999999999994,131.6,208.1,{"$f":"SUM(N2+$N$79)","v":92.5},158,247.5]
[null,null,null,"Region 22Enhanced Life $100,00050-99",70.2,113.7,161.69999999999999,81.599999999999994,137.6,215.6,87.6,151.1,240.6,104,180,285]
[null,null,null,"Region 11Enhanced Life $100,00050-99",62.7,96.2,135.69999999999999,72.099999999999994,115.6,180.1,79.099999999999994,127.1,199.1,90.5,150,237]
[null,null,null,"Region 12Enhanced Life $100,00050-99",69.2,108.7,155.19999999999999,80.599999999999994,131.6,206.1,86.6,144.1,230.1,102,172,271.5]
[]
[null,null,null,"Region 21Enhanced Life $150,00050-99",{"$f":"SUM(E2+$E$80)","v":74.7},112.2,153.69999999999999,{"$f":"SUM(H2+$H$80)","v":84.1},133.1,201.1,90.1,142.6,219.1,{"$f":"SUM(N2+$N$80)","v":103.5},169,258.5]
[null,null,null,"Region 22Enhanced Life $150,00050-99",81.2,124.7,172.7,92.6,148.6,226.6,98.6,162.1,251.6,115,191,296]
[null,null,null,"Region 11Enhanced Life $150,00050-99",73.7,107.2,146.69999999999999,83.1,126.6,191.1,90.1,138.1,210.1,101.5,161,248]
[null,null,null,"Region 12Enhanced Life $150,00050-99",80.2,119.7,166.2,91.6,142.6,217.1,97.6,155.1,241.1,113,183,282.5]
["List_VolDualChoiceSelection","List_VolOrtho"]
["Select Dual Choice (Required)","Select Ortho (Required)",null,"Region 21Standard Life Amount2-4",47.5,88,132.5,"NOT AVAILABLE"]
["Yes","Without Ortho",null,"Region 22Standard Life Amount2-4",55.5,102.5,154.5]
["No","With Ortho",null,"Region 11Standard Life Amount2-4",47.5,83.5,127]
[null,null,null,"Region 12Standard Life Amount2-4",55.5,97.5,148]
[]
[null,null,null,"List_RateTable_VOLPPO","ALL PLANS"]
[null,null,null,"Region 51With Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 52With Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 41With Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 42With Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 31With Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 32With Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"With Ortho",58,119,181.5,"X","X","X","X","X","X","X","X","X"]
[null,null,null,"Without Ortho",58,108.5,166.5,"X","X","X","X","X","X","X","X","X"]
[]
[null,null,null,"Region 51Without Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 52Without Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 41Without Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 42Without Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 31Without Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 32Without Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 1 & 21Without Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 1 & 22Without Ortho","X","X","X","X","X","X","X","X","X","X","X","X"]
[]
[]
[]
[null,null,null,"Enhanced Life Rates","GOOD",null,null,"BETTER",null,null,"BETTER PLUS",null,null,"BEST"]
[null,null,null,"$50,00010-49Enrolled",9.8000000000000007,null,null,8.4,null,null,8.4,null,null,7]
[null,null,null,"$100,00010-49Enrolled",23.8,null,null,22.4,null,null,22.4,null,null,21]
[null,null,null,"$150,00010-49Enrolled",37.799999999999997,null,null,36.4,null,null,36.4,null,null,35]
[]
[null,null,null,"$50,00050-99Enrolled",7.7,null,null,6.6,null,null,6.6,null,null,5.5]
[null,null,null,"$100,00050-99Enrolled",18.7,null,null,17.600000000000001,null,null,17.600000000000001,null,null,16.5]
[null,null,null,"$150,00050-99Enrolled",29.7,null,null,28.6,null,null,28.6,null,null,27.5]
[]
[]
[null,null,null,"List_RateTable_HMO","GOOD (2-99)",null,null,"BETTER (5-99)",null,null,"BEST (5-99)"]
[null,null,null,"Region 1 & 2Standard Life Amount2-4",26.5,40,57.5,30.5,45,64.5,34.5,49,71.5]
[null,null,null,"Region 3Standard Life Amount2-4",28.5,44,63.5,32.5,49,71.5,36.5,53,77.5]
[null,null,null,"Region 4Standard Life Amount2-4",30.5,46,67,34.5,51,74,38.5,56,80]
[null,null,null,"Region 5Standard Life Amount2-4",69,109,160.5,73,114,167.5,76,118,173.5]
[]
[null,null,null,"Region 1 & 2Standard Life Amount5-9",26.5,40,57.5,30.5,45,64.5,34.5,49,71.5]
[null,null,null,"Region 3Standard Life Amount5-9",28.5,44,63.5,32.5,49,71.5,36.5,53,77.5]
[null,null,null,"Region 4Standard Life Amount5-9",30.5,46,67,34.5,51,74,38.5,56,80]
[null,null,null,"Region 5Standard Life Amount5-9",69,109,160.5,73,114,167.5,76,118,173.5]
[]
[null,null,null,"Region 1 & 2Standard Life Amount10-49",26.5,40,57.5,30.5,45,64.5,34.5,49,71.5]
[null,null,null,"Region 3Standard Life Amount10-49",28.5,44,63.5,32.5,49,71.5,36.5,53,77.5]
[null,null,null,"Region 4Standard Life Amount10-49",30.5,46,67,34.5,51,74,38.5,56,80]
[null,null,null,"Region 5Standard Life Amount10-49",69,109,160.5,73,114,167.5,76,118,173.5]
[]
[null,null,null,"Region 1 & 2Standard Life Amount50-99",26.5,40,57.5,30.5,45,64.5,34.5,49,71.5]
[null,null,null,"Region 3Standard Life Amount50-99",28.5,44,63.5,32.5,49,71.5,36.5,53,77.5]
[null,null,null,"Region 4Standard Life Amount50-99",30.5,46,67,34.5,51,74,38.5,56,80]
[null,null,null,"Region 5Standard Life Amount50-99",69,109,160.5,73,114,167.5,76,118,173.5]
[]
[null,null,null,"Region 1 & 2Enhanced Life $50,00010-49",{"$f":"SUM(E84+$E$74)","v":36.299999999999997},49.8,67.3,{"$f":"SUM(H84+$H$74)","v":38.9},53.4,72.900000000000006,{"$f":"SUM(K84+$N$74)","v":41.5},56,78.5]
[null,null,null,"Region 3Enhanced Life $50,00010-49",38.299999999999997,53.8,73.3,40.9,57.4,79.900000000000006,43.5,60,84.5]
[null,null,null,"Region 4Enhanced Life $50,00010-49",40.299999999999997,55.8,76.8,42.9,59.4,82.4,45.5,63,87]
[null,null,null,"Region 5Enhanced Life $50,00010-49",78.8,118.8,170.3,81.400000000000006,122.4,175.9,83,125,180.5]
[]
[null,null,null,"Region 1 & 2Enhanced Life $100,00010-49",{"$f":"SUM(E84+$E$75)","v":50.3},63.8,81.3,{"$f":"SUM(H84+$H$75)","v":52.9},67.400000000000006,86.9,{"$f":"SUM(K84+$N$75)","v":55.5},70,92.5]
[null,null,null,"Region 3Enhanced Life $100,00010-49",52.3,67.8,87.3,54.9,71.400000000000006,93.9,57.5,74,98.5]
[null,null,null,"Region 4Enhanced Life $100,00010-49",54.3,69.8,90.8,56.9,73.400000000000006,96.4,59.5,77,101]
[null,null,null,"Region 5Enhanced Life $100,00010-49",92.8,132.80000000000001,184.3,95.4,136.4,189.9,97,139,194.5]
[]
[null,null,null,"Region 1 & 2Enhanced Life $150,00010-49",{"$f":"SUM(E84+$E$76)","v":64.3},77.8,95.3,{"$f":"SUM(H84+$H$76)","v":66.900000000000006},81.400000000000006,100.9,{"$f":"SUM(K84+$N$76)","v":69.5},84,106.5]
[null,null,null,"Region 3Enhanced Life $150,00010-49",66.3,81.8,101.3,68.900000000000006,85.4,107.9,71.5,88,112.5]
[null,null,null,"Region 4Enhanced Life $150,00010-49",68.3,83.8,104.8,70.900000000000006,87.4,110.4,73.5,91,115]
[null,null,null,"Region 5Enhanced Life $150,00010-49",106.8,146.80000000000001,198.3,109.4,150.4,203.9,111,153,208.5]
[]
[null,null,null,"Region 1 & 2Enhanced Life $50,00050-99",{"$f":"SUM(E84+$E$78)","v":34.200000000000003},47.7,65.2,{"$f":"SUM(H84+$H$78)","v":37.1},51.6,71.099999999999994,{"$f":"SUM(K84+$N$78)","v":40},54.5,77]
[null,null,null,"Region 3Enhanced Life $50,00050-99",36.200000000000003,51.7,71.2,39.1,55.6,78.099999999999994,42,58.5,83]
[null,null,null,"Region 4Enhanced Life $50,00050-99",38.200000000000003,53.7,74.7,41.1,57.6,80.599999999999994,44,61.5,85.5]
[null,null,null,"Region 5Enhanced Life $50,00050-99",76.7,116.7,168.2,79.599999999999994,120.6,174.1,81.5,123.5,179]
[]
[null,null,null,"Region 1 & 2Enhanced Life $100,00050-99",{"$f":"SUM(E84+$E$79)","v":45.2},58.7,76.2,{"$f":"SUM(H84+$H$79)","v":48.1},62.6,82.1,{"$f":"SUM(K84+$N$79)","v":51},65.5,88]
[null,null,null,"Region 3Enhanced Life $100,00050-99",47.2,62.7,82.2,50.1,66.599999999999994,89.1,53,69.5,94]
[null,null,null,"Region 4Enhanced Life $100,00050-99",49.2,64.7,85.7,52.1,68.599999999999994,91.6,55,72.5,96.5]
[null,null,null,"Region 5Enhanced Life $100,00050-99",87.7,127.7,179.2,90.6,131.6,185.1,92.5,134.5,190]
[]
[null,null,null,"Region 1 & 2Enhanced Life $150,00050-99",{"$f":"SUM(E84+$E$80)","v":56.2},69.7,87.2,{"$f":"SUM(H84+$H$80)","v":59.1},73.599999999999994,93.1,{"$f":"SUM(K84+$N$80)","v":62},76.5,99]
[null,null,null,"Region 3Enhanced Life $150,00050-99",58.2,73.7,93.2,61.1,77.599999999999994,100.1,64,80.5,105]
[null,null,null,"Region 4Enhanced Life $150,00050-99",60.2,75.7,96.7,63.1,79.599999999999994,102.6,66,83.5,107.5]
[null,null,null,"Region 5Enhanced Life $150,00050-99",98.7,138.69999999999999,190.2,101.6,142.6,196.1,103.5,145.5,201]
[]
[]
[null,null,null,"List_RateTable_VOLHMO","ALL PLANS"]
[null,null,null,"Region 1 & 2",26.5,41,64.5,"X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 3",29.5,45,70,"X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 4",30.5,48,74,"X","X","X","X","X","X","X","X","X"]
[null,null,null,"Region 5",74.5,114,173,"X","X","X","X","X","X","X","X","X"]